Prime Minister Jan ArogyaYojana [PMJAY]
- Government of India has launched Ayushman Bharat PradhanMantri Jan ArogyaYojana (PMJAY) on 23.09.2018. PMJAY is a centrally sponsored scheme. It is entirely funded by Government and the funding is shared between Centre and State governments as per prevailing guidelines of Ministry of Finance.
- PMJAY provides health coverage up to Rs. 5 lakh per family per year for secondary and tertiary hospitalization to around 10.74 crore poor and vulnerable families (approx. 50 crore beneficiaries).
- PMJAY is an entitlement-based scheme. This scheme covers poor and vulnerable families based on deprivation and occupational criteria as per SECC data.
- PMJAY provides cashless and paperless access to services for the beneficiary at the point of service in any (both public and private) empanelled hospitals across India. In other words, a beneficiary from one State can avail benefits from an empanelled Hospital anywhere in the Country.
- Under PMAJY, the States are free to choose the modalities for implementation. They can implement the scheme through insurance company or directly through the Trust/ Society or mixed model.
- There is no restriction on family size, ensuring all members of designated families specifically girl child and senior citizens get coverage.
- At the national level, the National Health Authority (NHA) has been set up to implement the scheme.
- AnMoU has been signed between National Health Agency (now National Health Authority) and 33 States/UTs to implement PMJAY.
- About 1393 treatment packages are available for the beneficiaries under PMJAY.
- The details of package, operational guidelines and key features are available at www. pmjay.gov.in
More than 1350 packages are available for the entitled beneficiaries of PMJAY. The details of package, operational guidelines and key features are available at www. pmjay.gov.in
The total number of hospitals empaneled under PMJAY is 14,440. Out of these, 7118 are public hospitals. The number of beneficiaries hospitalised under AB-PMJAY are 10,59,693.
As on 05.02.2019, 33 States/UTs have signed MoUs with National Health Agency (now National Health Authority), the implementing body for PMJAY. Only States of Telangana, Odisha, and Union Territory of Delhi have not signed the MoU.
Ayushman Bharat – Health and Wellness Centres
In order to expand access to Comprehensive Primary Health Care (CPHC), under Ayushman Bharat – Health and Wellness Centres (HWCs), Sub Health Centres (SHCs) and Primary Health Centres (PHCs) are being strengthened as Health and Wellness Centres (HWCs). The HWCs are to provide preventive, promotive, rehabilitative and curative care for an expanded range of services encompassing reproductive and child health services, communicable diseases, non-communicable diseases, palliative care and elderly care, oral health, ENT care, and basic emergency care. The services in HWCs will be provided through a Mid-level Health Care Provider (MLHP)/Community Health Officer (CHO) placed at a HWC-SHC and Medical Officer at PHC (Rural/Urban). The MLHP/CHO will undergo a Certificate in Community Health through IGNOU or public university.
The key elements for roll out of CPHC through HWC are as under:
• Expended Service Delivery.
• Continuum of Care – Tele-health/ Referral.
• Expanding HR- MLHP & Multiskilling.
• Medicines & Expanding Diagnostics.
• Community Mobilisation and Health Promotion.
• Robust IT System.
• Infrastructure.
• Partnership for Knowledge & Implementation.
• Financing/ Provider Payment Reforms.